Ezekiel Emanuel notices that inflated demand for antibiotics has led to overuse, and that antibiotic-resistant infections may be killing 23,000 Americans per year. He notices the pharmaceutical industry is focusing more on expensive non-cures for cancer that only extend life by months than on new antibiotics. But he hasn’t noticed that government intervention is causing these problems, so he thinks the solution is—you guessed it—even more government.

Government Inflates Demand for Antibiotics

In the Washington Post, Emanuel warns that “high patient demand leads to overprescribing” of antibiotics, which “breeds resistance” and can lead to superbugs against which we humans have no defenses.

Yet the main reason patient demand is so high is that the federal government—through Medicare, Medicaid, the tax code, Emanuel’s beloved ObamaCare, and other measures—have anesthetized patients to the cost of antibiotics and everything else. We would have less antibiotic overuse and resistance if government just let people keep their own money to spend on health care.

Government Distorts Pharmaceutical Research

Emanuel then complains pharmaceutical manufacturers are spending far more money to research and develop cancer treatments that only add a few months to cancer patients’ lives (and cost more than $100,000 a pop) that they spend developing lower-cost antibiotics.

If this state of affairs fails to reflect patients’ preferences, perhaps the reason is that Medicare offers to make drug companies and oncologists fantastically wealthy by paying for cancer treatments regardless of value.

Overprescribing Government

Rather than admit that government can be incompetent to the point of contributing to the problems it is trying to solve—as his fellow Obama-administration alumnus Larry Summers does—Emanuel doubles down on the Big Government ideology. He proposes requiring hospitals to track antibiotic (over)use as a condition of receiving Medicare subsidies.

Does it occur to Emanuel that a Medicare program stupid enough to subsidize five decades of antibiotic overuse might not be competent enough to track, much less solve that problem?

Next, Emanuel illustrates why the passive voice should be unconstitutional: “every antibiotic prescription should be electronically reviewed to be certain it meets national guidelines.” Like many devotees of the passive voice, Emanuel employs it to hide what he means, which is: “The federal government and its agents should review every antibiotic prescription you and your family receive, even when the government isn’t paying for it.”

What could possibly go wrong? I mean, can you imagine any reasons why people might want a little privacy when it comes to their use of antibiotics? Emanuel can’t—or he doesn’t care.

Finally, he proposes to have the federal government award $2 billion prizes to anyone who secures FDA approval for a new antibiotic. A system of prizes might actually do a better job than the federal government’s patent system of encouraging antibiotics R&D. But Emanuel does not address such thorny questions as who gets to define which new antibiotics will qualify; who sets the amount of the prize; what sort of complications financing the prizes would create; how this award would affect the FDA, and lobbying of the FDA; or whether the net effect of this system would be positive or negative.

Ezekiel Emanuel has no time for such trifles. He’s got himself a hammer, and by God he’s found a nail.

Conclusion

Government is like antibiotics. Some amount is necessary. But overprescribing it makes things a lot worse.

A good indication you’ve overdosed on the statist Kool-Aid is when you make dismissive comments like this one Emanuel levels at current antibiotic-tracking programs: “Unfortunately, they are voluntary.”

Given the push by Rep. Mike Pence (R-Ind.) to deny all federal funding to Planned Parenthood, are we seeing the revival of abortion as a major fault line in American politics?

My response:

Opponents of the push to deny federal funding to Planned Parenthood and other abortion providers will try to inflame the debate by characterizing the push as an attack on the Supreme Court’s discovery of a right to abortion. But the issue goes much deeper and is perfectly generalizable: it’s a push to get government out of one more controversial area of life.

Most modern liberals fail to grasp – or ignore – a fundamental principle of political theory, namely, that the more we do collectively, the more liberty is restricted and passions are inflamed. That’s why classical liberals asked government to provide only “public goods” like national defense, law enforcement, and clean air. Abortions are private goods (for some). Under current law, women are free to seek them from willing providers. And others are free to assist those who cannot afford an abortion. But no one should be compelled to provide or pay for another’s abortion. It’s a matter, quite simply, of freedom.

Back in August of 2007, I issued a challenge to Jesse Larner, who blogs at HuffingtonPost. One week later, Larner took up my challenge in a post that I’ve just finished reading.

Larner very graciously admitted to a couple of misstatements, and I must reciprocate. I wrote, “I challenge Larner to show where a Cato scholar … describes America’s as a ‘free-enterprise system of health care.’” Sure enough, Larner found an oped where one of my colleagues wrote, “I live in a country with a free-market health-care system.” Obviously, I disagree with that claim. But Larner was right, and I will have to look into this.

A few remaining areas of disagreement:

I wrote that Larner “claims that people don’t die on waiting lists in Canada’s health care system.” Larner responds: “Actually, that’s not what I claimed. I claimed that people don’t often die on waiting lists.” Canada’s Supreme Court writes that “in some serious cases, patients die as a result of waiting lists for public health care.” Is some as many as often? I hope not.

Larner: “the Canadian system has problems … [but] it worked better before a series of conservative provincial governments began to de-fund it.” This isn’t the first time that advocates of socialized medicine have blamed its shortcomings on politicians who (supposedly) oppose socialized medicine. But it is an inherent feature of such systems that they will inevitably fall into the hands of whatever viable political parties exist in that nation. As I explained to Paul Krugman, “Unless you have a plan to abolish Republicans, they’re part of your plan.”

Larner writes: “a public health care plan is a public good.” Public good is an economic term with a specific meaning. A public health care plan is not a public good.

Larner: “is Cannon saying that we do not have rationing in the US?” Hardly.

Larner: “In a free-market system, what mechanisms would prevent insurers from cherry-picking their customers, and denying coverage to those who are likely to require expensive treatment?” The question presumes that insurance should do something that insurance cannot do: insure the uninsurable. In this chapter of the Cato Handbook on Policy, I explain the (amazing) things that health insurance can accomplish, and why “health insurance markets are completely justified in not covering preexisting conditions.”

“So here’s my challenge to Cannon: show me a way that a true free-market system can provide decent coverage to everyone, regardless of ability to pay, without rationing.” Elsewhere in his post, Larner acknowledges this is an impossible task. In this magazine article, I explain that there is no way to reform health care that can guarantee that no patients will fall through the cracks. In this Cato paper, I explain how a free market would minimize the number of people who do.

“Cannon is not in favor of universal coverage as a social right.” True, that. “As a libertarian, he doesn’t even recognize the concept of social rights.” I believe it was Friedrich Hayek who said there’s no better way to strip a word of its meaning than to place the word “social” in front of it. Try it yourself . I suggest using words like security, contract, justice, responsibility…

I just came across this doozy in a 2009 report by MedPAC, the government agency that advises Congress on how to adjust Medicare’s price and exchange controls:

In broad terms, we must … invest in better information on the effectiveness of treatment options so it might guide the decisions of patients, health care providers, and public and private insurers. Our nation spends over $2 trillion on health care, yet we know far too little about the comparative effectiveness of alternative treatments. Such information is a public good, which has not—and will not—be [sic] spontaneously produced by the private market.

Except: the private market has spontaneously produced comparative-effectiveness information, as I documented in this study released one month prior to the MedPAC report. I also explain why the argument for government provision of public goods is shaky.

Ironically, MedPAC disables the “copy” function in the reports it posts online, so I had to type out the above excerpt by hand. Why is that ironic? It’s an example of the sort of innovation that enables markets to overcome the public-good problem. (But since my tax dollars paid for that report, it seems to be an innovation that maybe MedPAC could abandon.)

With unemployment continuing to climb and the economy struggling along, some lawmakers and pundits are raising the possibility of a second stimulus package at some point in the future. The Cato Institute was strongly opposed to the $787 billion package passed earlier this year, and would oppose additional stimulus packages on the same grounds.

“Once government expands beyond the level of providing core public goods such as the rule of law, there tends to be an inverse relationship between the size of government and economic growth,” argues Cato scholar Daniel J. Mitchell. “Doing more of a bad thing is not a recipe for growth.”

Mitchell narrated a video in January that punctures the myth that bigger government “stimulates” the economy. In short, the stimulus, and all big-spending programs are good for government, but will have negative effects on the economy.

Writing in Forbes, Cato scholar Alan Reynolds weighs in on the failures of stimulus packages at home and abroad:

In reality, the so-called stimulus package was actually just a deferred tax increase of $787 billion plus interest.

Whether we are talking about India, Japan or the U.S., all such unaffordable spending packages have repeatedly been shown to be effective only in severely depressing the value of stocks and bonds (private wealth). To call that result a “stimulus” is semantic double talk, and would be merely silly were it not so dangerous.

Palin’s future remains uncertain, but it’s hard to see how her cryptic and poorly drafted resignation speech positions her for a presidential run. Nonetheless, her departure presents a good opportunity to reflect on the Right’s affinity for presidential contenders who - how to put this? - don’t exactly overwhelm you with their intellectual depth.

It’s one thing to reject liberal elitism. It’s another thing to become so consumed with annoying liberals that you cleave to anyone they mock, and make presidential virtues out of shallow policy knowledge and lack of intellectual curiosity.

Writing at Politico, Cato scholars David Boaz and Roger Pilon weigh in on what her resignation means for the former Vice-Presidential candidate’s political future:

Will we one day say that her presidency was ‘born on the Fourth of July’? I doubt it. This appears to be just the latest evidence that Sarah Palin is not ready for prime time. The day McCain chose her, I compared her unfavorably to Mark Sanford. Despite everything, I’d still stand by that analysis. At the time I noted that devout conservative Ramesh Ponnuru said ‘Palin has been governor for about two minutes.’ Now it’s three minutes.

Running for president after a single term as governor is a gamble. Running after quitting in the middle of your first term is something else again. If this is indeed a political move to clear the decks for a national campaign, then she needs adult supervision soon. But I can’t really believe that’s what’s going on here. I suspect we’re going to hear soon about a yet-unknown scandal that was about to make continuing in office untenable.

It seems that since her return to the state following the campaign, activist opponents and bloggers have bombarded the governor’s office with endless document requests. And she’s faced 16 ethics inquiries, with no end in sight. All but one have since been resolved, but the politics of personal destruction has cost the state millions, as Palin noted. Add to that the unrelenting, often vicious and gratuitous attacks on her and even on her family, and it’s no wonder that she would say ‘Enough.’ It has nothing to do with ‘quitting’ or with being ‘unable to take the heat.’ It has everything to do with stepping back and saying you’re not willing to put your family and your state through any more. She seems confident that history will judge her more thoughtless critics for what they are. I hope she’s right.

Honduras’ President Is Removed from Office

In reaction to Honduran President Manuel Zelaya’s attempt to stay in power despite term limits set by the nation’s Constitution, armed forces removed him, sending the Latin American nation into political turmoil.

The removal from office of Zelaya on Sunday by the armed forces is the result of his continuous attempts to promote a referendum that would allow for his reelection, a move that had been declared illegal by the Supreme Court and the Electoral Tribunal and condemned by the Honduran Congress and the attorney general. Unfortunately, the Honduran constitution does not provide an effective civilian mechanism for removing a president from office after repeated violations of the law, such as impeachment in the U.S. Constitution. Nonetheless, the armed forces acted under the order of the country’s Supreme Court, and the presidency has been promptly bestowed on the civilian figure — the president of Congress — specified by the constitution.

To be sure, Hidalgo writes, the military action in Honduras was not a coup:

What happened in Honduras on June 28 was not a military coup. It was the constitutional removal of a president who abused his powers and tried to subvert the country’s democratic institutions in order to stay in office.

The extent to which this episode has been misreported is truly remarkable.